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Wednesday, October 2, 2013

Washington's Exchange - the Wahealthplanfinder.org - is up and running, but some people are still experiencing slow loading times and difficulty submitting their applications. The Exchange is taking the website down tonight starting at 10 p.m. until 6 a.m. tomorrow morning to work on system improvements. Want an update on their progress? Check www.wahbexchange.org often.

All individual and small employer health plans sold inside and outside the new Health Benefit Exchange - Wahealthplanfinder.org - must have an actuarial value of at least 60 percent.

This means the plan must pay for least 60 percent of your medical costs for essential health benefits. Sixty percent is the standard for the new 'bronze level' plans. You also can choose from a silver level or gold metal level plan. Silver plans pay for 70 percent of your costs and gold pay for 80 percent.

Here's answers to additional questions about how the new 'actuarial value' works:

If my plan has an actuarial value of
70 percent does that mean I will not have to pay more than 30 percent of my entire insurance
costs?

No, the
actuarial value is only based on the level of coverage the plan provides for
essential health benefits.If your plan
has an actuarial value of 60 percent, for example, that means that the plan will pay
60 percent of your covered expenses for essential health benefits and you pay 40 percent of
the covered expenses for essential health benefits.

Although the
actuarial value of your covered expenses for essential health benefits will be
covered, you may have other costs such as deductibles, copays and coinsurance,
as well as costs for services that are excluded or are not covered benefits.

Make sure
you read your policy to see what services are excluded services.Benefits
that are not covered would be subject to the terms of your insurance policy, so
it is important to read your policy before getting the service or
treatment.

What are essential
health benefits? As
of Jan. 1, 2014, all individual and small employer health plans must cover
these 10 benefits: